ALT、AST、ALP对病毒性肝炎患者病情发生发展的影响研究

A Study on the Influence of ALT,AST and ALP on the Occurrence and Development of Viral Hepatitis

目的观察病毒性肝炎患者ALT、AST、ALP水平,并分析其与病情变化的关系。方法选取2017年4月至2018年6月在我院接受治疗的病毒性肝炎患者为研究对象。根据其病情严重程度及有无腹水、肝性脑病等严重并发症分为无并发症组和有并发症组,所有患者均接受抗病毒、保肝治疗,同时选取体检健康者为对照。观察两组患者住院第二天ALT、AST、ALP水平、血脂和免疫指标的差异,分析病毒性肝炎患者ALT、AST、ALP水平与血脂和免疫指标的相关性。结果并发症组患者的ALT、AST、ALP水平分别为103.62±11.75 IU、113.27±13.51 IU、2.77±0.55 mg/L,高于无并发症组和对照组;并发症组患者的TC、TG、LDL水平分别为2.38±0.31 mmol/L、0.65±0.11 mmol/L、1.58±0.33 mmol/L,低于无并发症组和对照组(P<0.001);并发症组患者的CD4^+T水平高于无并发症组和对照组,CD8^+T水平低于无并发症组和对照组(P<0.001);病毒性肝炎患者的ALT、AST、ALP水平与TC、TG、LDL、CD8^+T水平负相关,与CD4^+T水平正相关。结论病毒性肝炎合并严重并发症的患者ALT、AST、ALP水平较高,且与血脂和免疫指标密切相关。

Objective To observe the levels of ALT,AST and ALP in patients with viral hepatitis,and to analyze their potential relationships.Methods Patients with viral hepatitis who were treated in our hospital from April,2017 to June,2018 were selected as study subjects.According to the severity of the disease and the presence or absence of serious complications such as ascites and hepatic encephalopathy,the patients were divided into the non-complication group and the complication group.All patients received anti-virus and liver-protection treatment,and the healthy subjects were selected as controls.The differences of ALT,AST,ALP levels,blood lipids and immune indexes between the two groups were evaluated.The correlations among ALT,AST and ALP levels and serum lipids and immune indexes in patients with viral hepatitis were analyzed.Results The levels of ALT,AST and ALP in patients with complications were 103.62±11.75,113.27±13.51 IU and 2.77±0.55 mg/L,respectively,which were higher than those of the uncomplicated group and the control group.The levels of TC,TG and LDL were 2.38±0.31mmol/L,0.65±0.11mmol/L,and 1.58±0.33mmol/L,respectively,which were lower than those without complications and the control group(P<0.001).The level of CD4^+T for patients with complications was higher than that of the uncomplicated group and the control group.The level of CD8^+T was lower than that of the uncomplicated group and the control group(P<0.001).In patients with viral hepatitis,the levels of ALT,AST,and ALP were negatively correlated with TC,TG,LDL and CD8^+T levels and positively correlated with CD4^+T levels.Conclusion Patients with viral hepatitis complicated with severe complications have higher levels of ALT,AST and ALP,and are closely related to blood lipids and immune indicators.